The document presents an implementation case of the ArcGIS platform by the Centers for Medicare & Medicaid Services (CMS) to combat fraud, waste, and abuse. It covers customer needs, deployment options, challenges faced, and lessons learned during the process. It emphasizes the importance of infrastructure, data integration, and effective communication throughout the implementation lifecycle.

1. Esri WebGIS Platform
How we implemented ArcGIS, and you can too.

2. Agenda
• Customer Need
• Deployment Option
• Towards Authority to Operate (ATO)
• Challenges
• Solutions
• Feedback
• Q&A
Feb 2017 Harsh Prakash, PMP, GISP 2 / 10

3. Customer Need
Centers for Medicare & Medicaid Services (CMS) – “In order to improve
the effectiveness of detecting and potentially preventing fraud, waste,
and abuse, CMS implemented the ArcGIS Platform as an additional BI
Tool.”
Anomalies & Outliers on the Map:
Referrals Made > 50% Change over Time Similar Providers
Isochrone Around Provider Travel Time of Service Stops
Providers by Specialty Code Closest Provider
Summarize Beneficiaries
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4. Big Data
(OLAP)
Deployment Option
Hybrid & Disconnected
• ArcGIS Portal, ArcGIS Servers (federated, cluster), ArcGIS Server
(unfederated, stand-alone), ArcGIS DataStore, StreetMap Premium
• ArcGIS Online
Feb 2017 Harsh Prakash, PMP, GISP 4 / 10

5. Towards ATO
Project
• Planning & Design
• Workshops – Hardware & Requirements
• eXpedited Life Cycle (XLC) Process – Technical Review Board (TRB)
• Architecture Review (AR)
• Preliminary Design Review (PDR)
• Detail Design Review (DDR)
• Security Control Assessment (SCA)
• User Acceptance Test (UAT)
• Operational Readiness Review (ORR)
Feb 2017 Harsh Prakash, PMP, GISP 5 / 10

6. Challenges
Environmental
• Not Public-facing – No PII/PHI could leave to arcgis.com
• 3-Zone Architecture – For ArcGIS token, needed to negotiate SSL
handshakes and establish trust to route authentication between daisy-
chained servers
• Multi-VPN & Multi-NICs – Different networks for different groups
Project-specific
• HTTPS – Needed to decrypt
• No Web Adapter – Needed to proxy without
• Red Hat Enterprise Linux (RHEL) Version – Support
• ODBC Driver – Teradata
Feb 2017 Harsh Prakash, PMP, GISP 6 / 10

7. API Query “Find all Providers X miles from Y for these Beneficiaries”
Foreground Data
From Integrated Data
Repository (IDR)
Background Map
From ArcGIS –
Internal & External
Web Application
Map Sandwich
Managerial
• Transparent Communication
• Timely Escalation
Technical
• Infrastructure as a Service (IaaS) – Rapid piloting & prototyping in Amazon Web Services (AWS) as
AWS Partner – Takeaway Alert!
• Internal Basemaps – e.g. Aerial imagery from National Agriculture Imagery Program (NAIP), USDA
• Citrix – For ArcGIS Desktop
• Pass-through System Design
• Reverse Proxy
Solutions
Feb 2017 Harsh Prakash, PMP, GISP 7 / 10
Fiddler

8. Solutions – Data
Technical
• StreetMap Premium – On-premise Geocoding – ¼ Billion!
Production (approx.)
• 121 million Beneficiary addresses
• 1.7 million Provider addresses
• 19 million Claim addresses
Validation (approx.)
• 121 million Beneficiary addresses
• 1.7 million Provider addresses
• 1.6 million Claim addresses
Development (approx.)
• 21 million Beneficiary addresses
• 1.6 million Provider addresses
• 1 million Claim addresses
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9. Lessons
• Advantages of ArcGIS
• COTS – Users & Roles, LDAP Integration, Security Model,
SDLC, etc.
• Raw Speed of Development – E.g Production-ready on-
premise on-the-fly drag-and-drop geocoding with a small team
in a few months
• Tight Peopleware Coordination – Esp. where
Horizontally Sliced Projects
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COTS
Custom
Development
Backend
Frontend
Infrastructure
Teams

10. Q&A
@gisblog
Feb 2017 Harsh Prakash, PMP, GISP 10 / 10